[Efficacy of surgical treatment of stress urinary incontinence with mini-invasive single incision sling]. / Výsledky operacní lécby stresové inkontinence moci mini-invazivní transobturatorní páskou z jedné inc.

OBJECTIVE: The purpose of this study is to evaluate the surgical treatment of stress urinary incontinence by the single incision sling Ophira (Promedon). DESIGN: Prospective observational study. SETTING: Department of Obstetrics and Gynaecology, Masaryk University and University Hospital Brno, Brno. METHODS: Patients with confirmed urodynamic stress urinary incontinence (SUI) were included in the study. Patients with urgent urinary incontinence or mixed incontinence with predominance of urgent folder, patients with insufficiency of internal sphincter of the urethra and pelvic organ prolapse, as well as after previous surgical treatment, patients with pelvic organ prolapse or with other serious pathology of organs of small pelvis were excluded. All patients included in the study received single incision sling (SIS) Ophira (Promedon). The length of the surgery and blood loss and complication was observed. Postoperative observation one year after the treatment was set and evaluated objective and subjective parameters of SUI. RESULTS: In the study were 138 patients examined, total of 45 (34.8%) were included. Postoperative observation completed 44 (97.7%) patients. Mean age was 62.3 years. The mean follow-up was 12.9 months, when 40 patients (90.9%) had a negative cough standardized test (CST). Total of 41 patients (93.1%) evaluated the operation as a major improvement by using a questionnaire Patient Global Impression of Improvement (PGI-I). Quality of life scores were evaluated by International Consultation on Incontinence Questionnaire - Short Form (ICIQ-SF). Before the surgery ranged from 14.8 ± 2.5 points, after the surgery 3.3 ± 2.0 which is an improvement of 11.5 ± 3.1 points. There weren't serious perioperative and postoperative complications. CONCLUSION: Our results are comparable with literary data and are correlated with other studies evaluating the effectiveness of other types of SIS. The method seems to be safe and efficient enough. Observing the group of patients will be continued in order to assess the short- and long-term results.

[The influence of breach position of the second twinon perinatal outcomes in vaginal births of bichorial - biamniotic twins after 33rd week of gravidity]. / Vliv naléhání druhého dvojcete koncem pánevním na perinatální výsledky pri vaginálním vedení porodu bichoriálních biamniálních dvojcat po 33. týdnu gravidity.

OBJECTIVE: The objective is to evaluate whether a breach presentation of the second twin has an influence on the perinatal results in vaginal births of bichorial-biamniotic twins after 33rd week of pregnancy. DESIGN: Retrospective analysis. SETTING: Department of Obstetrics and Gynecology, Masaryk University and University Hospital Brno. SAMPLE AND METHODS: The current study is a retrospective analysis of 695 vaginal births of bichorial-biamniotic twins after 33rd week of pregnancy. All births were conducted at the Department of Obstetrics and Gynecology, Masaryk University and University Hospital Brno during the span of 2004-2013. The sample was divided into2 groups. Group A consisted of 550 births of both twins in vertex presentation, group B consisted of 145 births in which the second twin happened to be in the breach presentation. The factors that have been evaluated include the percentage of births finished vaginally, perinatal results (pH a. umbilicalis below 7.0 and Apgar score in the 5th minute below 5) and early neonatal mortality and morbidity. Data from both groups have been compared with the use of Fishers exact test. RESULTS: For the group A, 81.3% of births were finished vaginally, as opposed to 85.5% in group B. Acute Caesarean sections conducted on the second twin consisted 4% (22 cases) in group A and 3.4% (5 cases) in group B. No significant difference has been found between the two groups in both perinatal results (p = 0.6 for pH from a. umbilicalis below 7.0 and p = 0.7 for Apgar score in the 5th minute below 5; both two-tailed) and in the frequency of early neonatal mortality and morbidity. In total,5 neonatal deaths have occured in 28 days after birth, out of which 2 have occured in group A and 3 in group B. CONCLUSION: It was concluded that breach presentation of the second twin does not influence perinatal results in vaginal births of bichorial-biamniotic twins. KEYWORDS: bichorial-biamniotic twins, vaginal birth, breach presentation, perinatal mortality, perinatal morbidity.

[Laparoscopically assisted neovagina formation--updated Vechieti surgery]. / Laparoskopicky asistovaná neoplastika pochvy podle Vecchiettiho.

UNLABELLED: AIMS OF THE WORK: To evaluate the file o patients operated for the agenesis of uterus and vagina by laparoscopic assisted neoplastic of vagina according to Vecchietti. TYPE OF THE STUDY: Original study. SETTING: Gynecologic-Obstetrics Dpt, Medical Faculty of Masaryk University and University Hospital, Brno. MATERIALS AND METHODS: The study included 13 patients operated from September 2000 until April 2011. The patients were operated for the agenesis of the uterus and vagina by laparoscopic assisted neoplastic of vagina with gradual retraction of the special "olive" into the retrovesical space. RESULTS: All of the operations were performed without any serious complication. The retraction of the olive was done once in 2 to 3 days. The dilatation period varied between 10 to 14 days. The length of the vagina, after removing the olive, was 8 to 10 cm. During examination, 2 to 4 months later, the length of the neovagina varied from 8 to 10 cm. During later follow-up controls, 11 patients reported regular sexual intercourse with which they were satisfied. CONCLUSION: This operation technique enables patients, with undeveloped vagina, satisfactory sexual life. Our results are comparable to the ones of the other authors.